Patient Registration

patient history form

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Complete and Send button at the bottom to automatically send us your information. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online Patient Registration

Have Confidence in Your Smile and Get in Touch!

Our Goal is to Make You Feel Comfortable and Relaxed While You Are a Guest in Our Office

Make an appointment by clicking below or calling us at (520) 790-2151

Make an Appointment